Results
A total of 105 home dialyses were
performed, from which 57 blood
samples were analyzed. The results
were compared with those from dia-
lyses using cannulas, in the same two
patients (Table I).
With the fistula technique higher
values of BUN and creatinine are
noted post dialysis in Case 1 and pre-
dialysis in Case 2. Both wives man-
aged the technique with reasonable
confidence. Complications, such as in-
fection,
clotting
and
hemorrhage,
were not seen in over 105 consecutive
dialysis. In Case 1 a small aneurysmal
dilatation developed near the wrist
joint but it does not interfere with
either work or dialysis. On only one
occasion was venipuncture unsuccess-
ful. Both patients are fully rehabili-
tated and have gone back to work.
Discussion
In accordance with the experience of
others,5' 6 A-V fistulas for home dia-
lysis involve no extra technical diffi-
culty but offer the following advan-
tages:
(1)
Fewer
complications,
particularly clotting and infection. (2)
No need for long-term anticoagula-
tion.
(3) Convenience and freedom
from concern over their function.
Until now we have reserved the
use
of
fistulas
for
patients
with
special
problems
limiting
cannula
survival,
as
in the cases reported.
However, in view of the acceptance
of this method a more widespread use
is planned.
References
1. BRESCIA, M. J. et al.: New Eng. J.
Med., 275: 1089, 1966.
2. PATEL, R.
et
al.:
Brit. Med. J.,
1:
414. 1968.
3. COHEN, S. et
cii.:
Trans. Amer. .Soc.
Artif. Intern. Organ.s, 14: 421, 1968.
4. KOLF'F, W.
J.,
NAKAMOTO,
S.
AND
SCUDDER, J. P.: Ibid., 8: 292, 1962.
5. SHALDON, S. AND MCKAY, S.:
Brit.
Med. .1., 4: 671. 1968.
6. CHINITE, J. et al.: J. A. M. A., 210:
1069. 1969.
A cold-weather "jogging mask" for
angina patients
T. KAVANAGH, M.D., Toronto
For the past two years we have con-
ducted
an
exercise
rehabilitation
course for coronary thrombosis pa-
tients. The basic activities of the pro-
gram
are
walking,
jogging
and
running. Within six months of joining
the class, most of the patients attain
a distance of two miles